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Positron Emission Tomography

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Unsuspected second malignancy detection by FDG PET scan.

Archi Agrawal¹, Narendra Nair, Ramesh Agrawal

¹Radiation Medicine Center, Port Trust Hospital, Parel, Mumbai, India. drarchi23@hotmail.com

Clinical Nuclear Medicine

|November 27, 2008

Summary

This summary is machine-generated.

A whole-body F-18 FDG PET scan revealed unexpected rectal uptake in a lung cancer patient. Subsequent scans showed a growing rectal mass, later diagnosed as adenocarcinoma.

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Area of Science:

Nuclear Medicine
Oncology
Gastroenterology

Background:

F-18 FDG PET/CT is crucial for staging and metastatic surveys in various cancers.
Small cell lung carcinoma (SCLC) has a high propensity for metastasis.

Observation:

A 45-year-old male with SCLC presented with intense F-18 FDG uptake in the primary lung tumor, hilar lymph nodes, and rectum.
Initial rectal uptake (SUVmax 21.73) was noted incidentally during a metastatic survey.
Follow-up PET revealed a significant increase in rectal uptake (SUVmax 83.22) and mass size.

Findings:

The initial PET scan identified an incidental finding of intense F-18 FDG uptake in the rectum.
A subsequent PET scan demonstrated progression of the rectal abnormality.
Biopsy confirmed invasive adenocarcinoma of the rectum.

Implications:

This case highlights the potential for F-18 FDG PET to detect unexpected findings, such as rectal adenocarcinoma, in cancer patients.
It underscores the importance of further investigation for focal intense uptake, even in the absence of symptoms.
Consideration of secondary malignancies or treatment-related changes is vital in interpreting PET scans.